Hip Implant Makers Scale Back Payments To Doctors

Weâ€™ve long pointed out that potential pitfalls and bias can occur when doctors maintain close financial ties with drug and medical device makers. Now, after settling a 2007 lawsuit, five of the largest artificial hip and knee implant makers are scaling back their payments to physicians.

The financial transactions are staggering. In 2007, 939 orthopedic surgeons received $198 million; in 2008, 568 payments totaling $119 million and $109 million in royalty buyouts from Zimmer were paid, according to the just-released Archives of Internal Medicine report, said Businessweek. Of the 25,000 orthopedic surgeons practicing in the United States, about 1,000 received money for consulting, product royalties, research, or clinical study work, said to the researchers, Businessweek wrote.

â€œWe live in a society where we want to reward people for innovation and ingenuity and participation in technology development,â€ lead researcher Jason Hockenberry, assistant professor of health policy and management at Atlantaâ€™s Emory University, told Businessweek in an interview. â€œAt the same time, we need to manage the potential conflicts of interest that arise from these financial relationships,â€ he added.

In 2007, the device makers agreed to a $311 million fine to settle U.S. Department of Justice claims they paid kickbacks to surgeons in exchange for the physiciansâ€™ promises to only use their medical devices, Businessweek explained. Under the agreement, prosecutors deferred criminal charges and mandated the device makers disclose their physician consulting agreements, publicize payout amounts on their corporate webs sites; and give federal monitors oversight access.

Researchers reviewed two more years of disclosure from DePuy, Smith & Nephew, and Stryker, which voluntarily provided data, and found that while the number and amounts given to academic researchers increased, they were not as high as the 2007 figures, according to the report, said Businessweek. The number of payments in amounts of $1 million or more showed no significant change, while the largest decrease was seen in the smallest surgeons fees, said Hockenberry.

As weâ€™ve long written, the financial relationships between the drug and medial device industries and doctors have caused enormous controversy in recent years. Critics have long held that such relationships create conflicts of interest and could unduly influence everything from research findings to prescribing practices.

In response to the ongoing outcry, several states, medical schools, medical societies, and other entities have passed regulations requiring doctors to disclose their financial relationships with drug and device makers; some have attempted to curb doctor payments and the gifts and perks doctors can receive.